Older people often have multiple health conditions requiring medical attention. As a result, they often must juggle complex medication schedules, doctors’ appointments and diagnostic tests—all of which can lead to fragmented and burdensome care that does not focus on what matters most to them.
Over the past five years, researchers from NYU School of Medicine, along with a national group of researchers, clinicians, policymakers, payers, patients, caregivers, and healthcare system representatives designed and piloted Patient Priorities Care (PPC). PPC is a new approach to healthcare which helps patients and clinicians focus decision-making on patients’ health priorities, defined as both their health outcome goals—what they want from their healthcare, and their healthcare preferences—the healthcare activities they are able and willing to do.
A new feasibility study published online in the Journal of the American Geriatrics Society (JAGS), describes a pilot study that took place at a primary care and cardiology practice in central Connecticut. In the study, a trained member of the healthcare team elicited detailed health priorities from 119 study participants. These priorities were entered into the electronic health record accessible to patient primary care providers, and transmitted to their cardiologists, to ensure that all care was aligned with patient priorities. Care providers also worked closely with the researchers to embed these patient priorities into clinical workflow.
“Healthcare providers often focus on a particular medical condition and, as a result, lose focus on what is most important to a patient,” said Caroline S. Blaum, MD, the Diane and Arthur Belfer Professor of Geriatric Medicine and director of the Division of Geriatric Medicine and Palliative Care. “Patient Priorities Care aligns clinical decision-making with patient priorities, offering promise of better health outcomes and greater patient satisfaction.”
Findings demonstrate that patients and clinicians can participate in current care planning about clinical decision-making based on patients’ priorities in routine clinical care. More research is needed in different settings, and to more effectively measure the impact of PPC on the care and health of adults with multiple conditions.
An editorial written by the editors of JAGS, published alongside Dr. Blaum’s article and companion article by Dr. Aanand Naik of Baylor College of Medicine, which details the priorities elicitation process, states that PPC offers a “revolutionary change” in healthcare design and delivery, which is truly person-centered.
Dr. Blaum and her research colleagues from Yale School of Medicine and Baylor College of Medicine have developed workflows and tools tested in this study that can be adopted by other health teams. These tools and other resources for patients, clinicians, caregivers, and health systems are available at patientprioritiescare.org.
Funding support for this research was provided by the John A. Hartford Foundation, the Patient-Centered Outcomes Research Institute (PCORI), the Gordon and Betty Moore Foundation, and the Robert Wood Johnson Foundation.